台灣中部某醫學中心沙門氏菌病患流行病學暨Salmonella enterica serovar Enteritidis感染之流行病學特徵探討

Epidemiology of Salmonella infection and Identification of Epidemiological Characteristics of S. enterica Serovar Enteritidis in Patients from a Medical Center in Central Taiwan

10.6288/TJPH2009-28-05-09

李宗賢(Tsung-Hsien Li)；陳志銘(Chih-Ming Chen)；陳宛青(Wan-Ching Chen)；柯瑟琴(Se-Chin Ke)；徐媛曼(Yuan-Man Hsu)；張照勤(Chao-Chin Chang)

S. Enteritidis ； 雞蛋 ； 有機蔬菜 ； 流行病學 ； S. Enteritidis ； egg ； organic vegetable ； epidemiology

台灣公共衛生雜誌

28卷5期（2009 / 10 / 01）

446 - 453

繁體中文

目標：藉由醫學中心的沙門氏菌感染臨床個案探討其流行病學特徵，並進一步分析病患感染Salmonella enterica serovar Enteritidis (S. Enteritidis)的相關流行病學特徵。方法：收集於醫學中心就診的人類沙門氏菌症病患及菌株，病患利用問卷訪視方式，獲得人口學資料、發病前一個月內其居家環境、畜產動物暴露史、豬畜產品的食用史、飲用水源以及居家飲食烹調和公共衛生習慣等相關資訊。進一步依照病人感染之沙門氏菌株血清型別分成S. Enteritidis感染者和非S. Enteritidis感染者，進行病例-病例比較研究(case-case comparison)以找出相關的流行病學特徵因子。結果：感染病患所屬血清群當中，以血清群D1的42.6% (26/61)和血清群B的32.8%(20/61)為主；若以血清型而言，以S. Enteritidis佔42.6% (26/61)、S. Typhimurium佔21.3% (13/61)及S. Stanley的9.8% (6/61)為最盛行的型別。單變項分析結果顯示發病前一個月內曾經食用雞蛋或有機蔬菜為感染S. Enteritidis的重要流行病學特徵，其危險勝算比分別為4.1 (95% CI: 1.4-12.2)及4.5(95% CI: 1.4-14.5)。結論：本研究提供中台灣之沙門氏菌病患流行病學特徵，並且為台灣首次針對S. Enteritidis感染的相關流行病學特徵所進行之研究。相較於其他非S. Enteritidis的沙門氏菌感染病患，S. Enteritidis 的感染患者與蛋或有機蔬菜之食用有密切相關。未來對於教育民眾並宣導如何正確且安全的飲食習慣，為防治S. Enteritidis之重要方向。

Objectives: The objectives of this study were to understand the epidemiology of Salmonella infections in humans in Taiwan, and to identify the epidemiological characteristics associated with S. Enteritidis infection. Methods: 61 patients from a medical center in central Taiwan with confirmed cases of Salmonella infection were interviewed with a structured questionnaire to collect information with regard to demographic data as well as proximity to pig farms, history of animal contacts, consumption of animal products, source of drinking water, and kitchen hygiene. All exposure information was traced back for one month prior to the onset of illness. Patients infected with Salmonella other than S. Enteritidis served as references, and a case-case comparison study was conducted to identify epidemiological characteristics associated with S. Enteritidis infection. Results: The results indicated that the main sero-groups of Salmonella in patients were sero-groups D1 (42.6%; 26/61) and B (32.8%; 20/61). After serotyping, it was determined that the most three prevalent Salmonella serotypes were S. Enteritidis (42.6%; 26/51), S. Typhimurium (21.3%; 13/61) and S. Stanley (9.8%; 6/61). By univariate analysis, consumption of eggs (odds ratio: 4.1; 95% CI: 1.4-12.2) and organic vegetables (odds ratio: 4.5; 95% CI: 1.4-14.5) were found to be significant epidemiological characteristics associated with S. Enteritidis infection. Conclusions: Consumption of eggs and organic vegetables may play an important role in the transmission of S. Enteritidis in Taiwan. Therefore, public health education, especially with regard to proper food handling, is necessary to prevent people from contracting an S. Enteritidis infection.

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